HomeMy WebLinkAboutAGMT - AIS Construction Company #50147RECORDING REQUESTED BY
AND WHEN RECORDED MAIL TO
CITY OF SEAL BEACH
Attn: City Clerk
2118 th Street
Seal Beach, CA 90740
Recorded in Official Records, Orange County
Tom Daly, Clerk- Recorder
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Space of above this line for Recorder's use.
* ** No Recording Fee Pursuant to Government Code Section 6103, 27383
NOTICE OF COMPLETION
Notice pursuant to Civil Code Section 3093, must be filed within 10 days after completion.
Notice is hereby given that:
1. The undersigned is owner or corporate officer of the owner of the interest or estate stated below in the
property hereinafter described:
2. The full name of the owner is: City of Seal Beach
3. The address of the owner is: City of Seal Beach; 211- 0 Street, Seal Beach, CA -90740
4. The nature of the interest or estate of the owner is; In fee. The City of Seal Beach.
5. A work of improvement on the property hereinafter is described as substantially completed on
September 1, 2006 The work was: Sand Retention Groin Repair Project 50147.
6. The name of the contractor, for such improvement was: AIS Construction Company. The date of the
Contract Award was: December 12, 2005.
7. The property on which said work of improvement was completed in the City of Seal Beach, County of
Orange State of California, and is described as follows: Seal Beach Municipal Pier and Beach.
Date: t�
Signature of owner or corporate o 0 owner
named in paragraph 2 or his age t.
VERIFICATION
1, the undersigned, say: the Director of Public Works declarant of the foregoing notice of completion; have
read said notice of completion and know the contents thereof; the same is true of my own knowledge.
I declare under penalty of perjury the foregoing is true and correct.
Executed on /2 ° 2 1 °0? , 2006, at Seal Beach, California.
(Date of Signature)
Director of Public Works
•
•
CONTRACTOR TO PRINT COMPANY BOOK IT OF III
•
NAME:
0 416 ems mit 41(AA1 CONTRACT DOCUMENTS
EMENT OF
DOCUMENTS TO SUBMIT UPON AWARD:
❑ PUBLIC WORKS CONTRACT ❑ ACKNOWLEDG
❑ PERFORMANCE BOND LICENSE LAW
CI PAYMENT BOND ❑ WORKMEN'S COMPENSATION
CERTIFICATE
❑ INDEMNIFICATION AND HOLD ❑ INSURANCE REQUIREMENTS (3)
ARMLESS
❑ LABOR LAW REQUIREMENTS
FOR:
SAND RETENTION GROIN REPAIR
CITY PROJECT NUMBER:
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5 014'7 , ��x
B f'W C"atl I Y
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These Contract Documents these are the exclusive property of the Others Agency shall be at Other's and shall not be used in any manner withou prior consent of the
Agency. Any reuse of plans and specifications by risk and without liability t the Agency.
CITY OF SEAL BEACH - 211 EIGHTH STREE -SEA sale BEACH, CA 90740 -6379.
1
TABLE OF CONTENTS
CONTRACT DOCUMENTS 1
DOCUMENTS TO SUBMIT UPON AWARD: 1
PUBLIC WORKS CONTRACT 3
PERFORMANCE BOND 5
PAYMENT BOND 7
INDEMNIFICATION AND HOLD HARMLESS AGREEMENTAND WAIVER OF
SUBROGATION AND CONTRIBUTION 9
AGREEMENT TO COMPLY WITHCALIFORNIA LABOR LAW REQUIREMENTS
10
STATEMENT ACKNOWLEDGING PENAL AND CIVIL PENALTIES
CONCERNING THE CONTRACTORS' LICENSING LAWS 12
INSURANCE REQUIREMENTS 15
WORKER'S COMPENSATION CERTIFICATE OF INSURANCE 17
ADDITIONAL INSURED ENDORSEMENT COMPREHENSIVE GENERAL
LIABILITY 18
ADDITIONAL INSURED ENDORSEMENT AUTOMOBILE LIABILITY 21
ADDITIONAL INSURED ENDORSEMENT EXCESS LIABILITY 23
2
• •
•
• PUBLIC WORKS CONTRACT
For the following project named Sand Retention Groin Repair, in the City of Seal Beach.
THIS AGREEMENT, made and entered into this 12 day of l� Q QX {✓20 6.57 and
between the City of Seal Beach, - Caaliffornia, hereinafter referred to as the "CITY," Party of the First Part,
an l+`�
5 WY i m� liUYY `
hereinafter designated as the "CONTRACTOR," Party o the Seco d Part.
WITNESSETH: That the Parties do hereto mutually agree as follows:
ARTICLE I. For and in consideration of the payments and agreements hereinafter mentioned to be
made and performed by said CITY, the CONTRACTOR agrees with said CITY to perform and complete
in a good and workmanlike manner all the work pertaining thereto shown on the drawings and described in
the Specifications and Contract Documents, therefore, to furnish at his own proper cost and expense all
tools, equipment, labor and materials necessary therefore (except those materials expressly noted as to be
furnished by the CITY), and to do everything required by this Agreement and the said Specifications,
Drawings, and Contract Documents.
•
ARTICLE H. For famishing all said materials and labor, furnishing and removing all plant, temporary
works or structures, tools and equipment and doing all the work contemplated and embraced in this
Agreement, also for all loss and damage arising out of the nature of the work aforesaid, or from the action
of the elements, or from any unforeseen difficulties which may arise or be encountered in the prosecution
of the work until its acceptance by said CITY, and for all risks of every description connected with the
work; also for all expenses incurred by or in consequence of the suspension or discontinuance of work;
except such as in the said Specifications are expressly stipulated to be borne by the said CITY and
faithfully completing the work and the whole thereof, in the manner shown and described in the said
Drawings, Specifications, and Contract Documents and in accordance with the requirements of the
Engineer, said CITY will pay and the CONTRACTOR shall receive in full compensation, therefore, the
unit prices and the lump sum prices named in the Schedule of Work Items of the Proposal.
ARTICLE III. The CITY hereby promises and agrees with said CONTRACTOR to employ and does
hereby employ said CONTRACTOR to provide the materials and to do the work according to the terms and
conditions herein contained and referred to for the price aforesaid, and hereby contracts to pay the same, at
the time, in the manner and upon the conditions set forth in the Specifications and Contract Documents, and
• the said parties for themselves, their heirs, executors, administrators, successors and assigns, do hereby
agree to the full performance of the covenants herein contained.
ARTICLE IV. The advertisement for Bids, the Proposal, the Specifications, and the Drawings mentioned
therein, and all addenda issued by the CITY with respect to the foregoing prior to the opening of bids, are
hereby incorporated in and made a part of this Agreement.
• ARTICLE V. The statement of prevailing wages appearing in the General Prevailing Wage Rates is
hereby specifically referred to and by this reference is made a part of this contract. It is further expressly
agreed by and between the parties hereto that should there be any conflict between the terms of this
instrument and the bid of proposal of said CONTRACTOR, then this instrument shall control and nothing
herein shall be considered as an acceptance of the said terms of said proposal conflicting herewith.
ARTICLE VI. By my signature hereunder, as CONTRACTOR, I certify that I am aware of the provisions
of Section 3700 of the Labor Code which require every employer to be insured against liability for
workmen's compensation or to undertake self - insurance in accordance with the provisions of that code, and
I will comply with such provisions before commencing the performance of the work of this contract
3
•
• •
IN WITNESS WHEREOF: The Parties hereto have caused .' • ontract to be executed the day and year
first above written.
CITY • E. :.ACH, CAL .a •
Party .f the ' • As ,
BY ,
City • ger
A / EST:
Ci Cle
Ci Clerk
:Y .1, ad/
T' • O' -Party of • And Part
•
itle
Address
p 9-4 to a-0 VeKra i (4 30 0 2__
et ooKED T cjn 2.6 ti
•
•
•
4
•
c
Bond No. Bond Premium
PERFORMANCE BOND
KNOW ALL PERSONS BY THESE PRESENTS that:
WHEREAS the City of Seal Beach, has awarded
(Name and address Contractor)
( "Principal "), a contract (the "Contract ") for the work described as follows: Sand Retention Groin Repair,
including removal of existing temporary steel repair, removal of a portion of the existing concrete cap,
furnishing and installing new precast concrete sheetpiles, construction of new concrete cap, and, as
directed, repair of remaining concrete cap.
WHEREAS, Principal is required under the terms of the Contract to furnish a bond for the faithful
performance of the Contract.
NOW, THEREFORE, we, the undersigned Principal, and
• (Name and address of Surety)
( "Surety") a duly admitted surety insurer under the laws of the State of California, as Surety, are held and
firmly bound unto the Public Agency in the penal sum of
Dollars ($ ), this amount being not less than the total
contract price, in lawful money of the United States of America, for the payment of which sum well and
truly to be made, we bind ourselves, our heirs, executors, administrators, successors, and assigns, jointly
and severally, firmly by these presents.
THE CONDITION OF THIS OBLIGATION IS SUCH THAT, if the hereby bounded Principal, his, her
or its heirs, executors, administrators, successors or assigns, shall in all things stand to and abide by, and
well and truly keep and perform all the undertakings, terms, covenants, conditions and agreements in the
Contract and any alteration thereof made as therein provided, on the Principal's part to be kept and
performed, all within the time and in the manner therein specified, and in all respects according to their true
intent and meaning, and shall indemnify and hold harmless the Public Agency, its officers, agents, and
others as therein provided, then this obligation shall become null and void; otherwise, it shall be and remain
• in full force and effect.
In case suit is brought upon this bond, Surety further agrees to pay all court costs and reasonable attorneys'
fees in an amount fixed by the court.
FURTHER, the Surety, for value received, hereby stipulates and agrees that no change, extension of time,
alteration, addition or modification to the terms of the Contract, or of the work to be performed thereunder,
or the specifications for the same, shall in any way affect its obligations under this bond, and it does hereby
waive notice of any such change, extension of time, alteration, addition, or modification to the terms of the
Contract or to the work or to the specifications thereunder. Surety hereby waives the provisions of
California Civil Code §§ 2845 and 2849, The City is the principal beneficiary of this bond and has all
5
ORIGINAL 4111 •
THE PREMIUM IS PREDICATED ON
• THE FINAL CONTRACT PRICE AND
IS SUBJECT TO ADJUSTMENT
ISSUED IN TWO ORIGINAL COUNTERPARTS
COUNTERPART NO. G
Bond No. SU5019227 Bond premium $1 4,102.00
PERFORMANCE BOND
KNOW ALL PERSONS BY THESE PRESENTS that
WHEREAS the City of Seal Beach, has awarded AIS CONSTRUCTION COMPANY,
4285 CROOKED PALM ROAD VENTURA, CA 93002
(Name and address of Contractor) -
( "Principal "), a contract (the "Contract ") for the work described as follows: Sand Retention Groin Repair,
including removal of' existing temporary steel repair, removal of a portion of the existing concrete cap,
furnishing and installing new precast concrete sheetpiles, construction of new concrete cap, and,' as
directed, repair of remaining concrete cap,
W1EREAS, Principal is required under the terms of' the Contract to furnish a bond for the faithful
perfgrrnance of the Contract.
NOW TZREFORE, we, the undersigned Principal, and ARCH INSURANCE COMPANY,
135 N. LOS ROBLES AVE., #825, PASADENA, CA 91101
•
(Name and address of Surety)
( "Surety ") a duly admitted surety insurer tinder the laws of the State of California, as Surety, are held and
firmly bound unto the Public Agency in the penal Bute of SEVEN HUNDRED EIGHTY THREE THOUSAND FOUR
HUNDRED FIFTY AND 00 /100'S
Dollars ($ 783, 450.00 ), this amount being not less than the total
contract price, lawful money of the United States of Auneiica, for the payment of which sum well and
truly to be made we bind ourselves, our heirs, executors, administrators, successors, and assigns, jointly
and severally, firmly by these presents.
THE CONDITION OF THIS OBLIGATION 15 SUCH THAT, if the hereby bounded Principal, his, her
or its heirs, executors, administrators, successors or assigns, shall in all things stand to and abide by and
well and truly keep and perform all the undertakings, terms, covenants, conditions and agreements in the
Contract and any alteration thereof made as therein provided, on the Principal's part to be kept and
performed, all within the time and in the manner therein specified, and in all respects according to their true
intent and meaning, and shall indemnify and hold harmless the Public Agency, its officers, agents, and
others as therein provided, the this obligation shall become null and void; otherwise, it shall be and restrain
in fall force and effect.
In case suit is brought upon this bond, Surety further agrees to pay all court costs and reasonable attorneys'
fees in an amount fixed by the court.
FURTHER, the Surety, Tor value received, hereby stipulates and agrees that no change, extension of time,
alteration, addition or modification to the terms of the Contract, or of the work to be performed thereunder,
or the specifications for the same, shall in any way affect its obligations under this bond, and it does hereby
waive notice of any such change, extension of time, alteration, addition, or modification to the terms of the
Contract or to the work or to the specifications thereunder. Surety hereby waives the provisions of
California Civil Code §§ 2845 and 2849. The City is the principal beneficiary of this bond and has all
5
4 • •
rights of a party hereto. IN WITNESS WHEREOF, two (2) identical counterparts of this instrument, each
of which shall for all purposes be deemed an original hereof, have been duly executed by Principal and
Surety, on the date set forth below, the name of each corporate party being hereto affixed and these
presents duly signed by its undersigned representative(s) pursuant to authority of its governing body.
Dated!
"Prineipid" "Surety"
AIS CONSTRUCTION COMPANY ARCH INSURANCE COMPANY
ANDY SHEAFF a im OULI1'LEONARD
B (111./WPW
Its ATTORNEY IN FACT
By: i • A By.
Itsw Its
•
(Seal) (Seal)
•
Note: This bond must be dated, all signatures must be notarized and
evidence of the authority of any person signing as attorney -in -fact must be
attached
•
•
•
6
- CALIFORNIA ALL-PURPOR ACKNOWLEDGEMENT
•
State of CALIFORNIA
County of RIVERSIDE
On JAN 11 g 2006 before me, DANNA K. BAKER, NOTARY PUBLIC
Name and Title of Officer (e.g., "Jane Doe, Notary Public ")
personally appeared JULIA B. LEONARD, ATTORNEY IN FACT
Name(s) of Signer(s)
• personally known to me -OR- ❑ proved to me on the basis of satisfactory evidence to be the person(s) whose
name(s) is /are subscribed to the within instrument and
acknowledged to me that he /she /they executed the same in
his /her /their authorized capacity(ies), and that by his /her /their
signature(s) on the instrument the person(s), or the entity upon
DANNA K. BAKER behalf of which the person(s) acted, executed the instrument.
�► COMM. #1386368
NO TARY PUBLIC • CALIFORNIA
- r RIVERSIDE COUNTY WITNESS my hand and official seal.
�1 - ° M Comm. E rea Nov. 22, 2008
Signature of Notary Public
Though the Information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal
and reattachment of this form to another document.
Description of Attached Document
Title or Type of Document:
Document Date: Number of Pages:
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name: Signer's Name:
❑ Individual ❑ Individual
❑ Corporate Officer ❑ Corporate Officer
❑ Titles(s): ❑ Title(s):
❑ Partner - ❑ Limited ❑ General ❑ Partner - ❑ Limited ❑ General
❑ Attorney -in -Fact ❑ Attorney -in -Fact
❑ Trustee RIGHT THUMBPRINT ❑ Trustee RIGHTTHUMBPRNT
❑ Guardian or Conservator OF SIGNER ❑ Guardian or Conservator OF SIGNER
❑ Other: Top of Thumb here ❑ Other: Top of Thumb here
Signer Is Representing: Signer Is Representing:
BD -1133 09/00
�. i • •
POWER OF ATTORNEY
ISSUED IN TWO ORIGINAL COUNTERPARTS BOND NO. SU5019227
Know All Men By These Presents
That the Arch Insurance Company, a corporation organized and existing under the laws of the State of Missouri, having its
principal office in Kansas City, Missouri (hereinafter referred to as the "Company ") aoes hereoy appoint
Kenneth A Coate, Mark N. Gladding and Julia B. Leonard of Riverside, CA (EACH)
its true and lawful Attorney(s) -in -Fact, to make, execute, seal, and deliver_from the date of issuance of this power for and
on its behalf as surety, and as its act and deed:
Any and all bonds and undertakings
EXCEPTION: NO AUTHORITY is granted to make, execute, seal and deliver bonds or undertakings that guarantee the
payment or collection of any promissory note, check, draft or letter of credit.
This authority does not pen the same obligation to be split into two or more bonds in order to bring each such bond
within the dollar limit of authority as set forth herein.
The Company may revoke this appointment at any time.
The execution of such bonds and undertakings in pursuance of these presents shall be , binding upon the said
Company as fully and amply to all intents and purposes, as if the same had been duly executd and acknowledged by its
regularly elected officers at its principal office in Kansas City, Missouri. .
This Power of Attorney is executed by authority of resolutions adopted by unanimous consent of the Board of Directors of
the Company on March 3, 2003, true and accurate copies of which are hereinafter set forth and are hereby certified to by
the undersigned Secretary as being in full force and effect
"VOTED, That the Chairman of the Board, the President, or any Vice President, or their appointees designated in writing
and filed with the Secretary, or the Secretary shall have the power and authority to appoint agents and attomeys -in -fact,
and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto, bonds and
undertakings, recognizances, contracts of indemnity and other writings, obligatory in the nature thereof, and any such
officers of the Company may appoint agents for acceptance of process."
This Power of Attorney is signed, sealed and certified by facsimile under and by authority of the following resolution
adopted by the unanimous consent of the Board of Directors of the Company on March 3, 2003:
VOTED, That the signature of the Chairman of the Board, the President, or any Vice President, or their appointees
designated in writing and filed with the Secretary, and the signature of the Secretary, the seal of the Company, and
certifications by the Secretary, may be affixed by facsimile on any power of attorney or bond executed pursuant to the
resolution adopted by the Board of Directors on March 3, 2003, and any such power so executed, sealed and certified
with respect to any bond or undertaking to which it is attached, shall continue to be valid and binding upon the Company.
00ML0013 00 03 03 ,
Page 1 of 2 Printed in U.S.A.
• • t
In Testimony Whereof, the Company n as caused this instrument to De signed and its corporate seal to be affixed Dy their
authorized officers. this 18th day of September . 20 03
Aron Insurance Company
Attested ana Certified
C CQ
CORPORATE
V SELL
Q 1971 (
e.'40 Missouri \---ZWeg-/00 ,, - „ 1.1 -- "e---
Joseph S L -. I, Corporate Secretary Thomas P. Luckstone, Vice President
STATE OF CONNECTICUT SS
COUNTY OF FAIRFIELD SS
1 Melissa B. Gilligan, a Notary Public, do hereby certify that Thomas P. Luckstone and Joseph S. Label) personally known
to me to be the same persons whose names are respectively as Vice President and Corporate Secretary of the Arch
Insurance Company, a Corporation organized and existing under the taws of the State of Missouri, subscribed to the
foregoing instrument, appeared before me this day in person and severally acknowledged that they being thereunto duly
authorized signed, sealed with the corporate seal and delivered the said instrument as the free and voluntary act of said
corporation and as their own free and voluntary acts for the uses and purposes therein set forth.
OFFICIAL SEAL , 1
MELISSA B. GNIIGAN, Notary Pubic ' I A A/ APO _ _ L 4r
State of Connecticut Melissa B. Gilligan, Notary Public
My Con mussion Expires February 28, 2005 My commission expires 2 -28 -05
CERTIFICATION
I, Joseph S. Labell, Corporate Secretary of the Arch Insurance Company, do hereby certify that the attached Power of
Attorney dated September 18. 2003 on behalf of the person(s) as listed above is a true and correct copy and that
the same has been in full force and effect since the date thereof and is in full force and effect on the date of this certificate;
and I do further certify that the said Thomas P. Luckstone, who executed the Power of Attorney as Vice President, was on
the date of execution of the attached Power of Attorney the duly elected Vice President of the Arch Insurance Company.
IN TESTIMONY WHEREOF, I have hereunto subscribed my name and affixed the corporate seal of the Arch Insurance
Company on this 13TH day of JANUARY 20 06
4
Joseph S ell, Corporate Secretary
This Power of Attorney limits the acts of those named therein to the bonds and undertakings specifically named therein
and they have no authority to bind the Company except in the manner and to the extent herein stated.
-c_ovance Cn
CORPORATE D
t t
Q SEAL =
Q 9n q
Home Office: Kansas City, MO
00ML0013 00 03 03
Page 2 of 2 Printed in U.S.A.
ORIGINAL • .
ISSUED IN TWO ORIGINAL COUNTERPARTS
COUNTERPART NO. 2
Bond No. SU5019227 B Premium INCLUDED IN THE PPEMIUM CHARGED
FOR THE PERFORMANCE BOND
PAYMENT BOND
(LABOR AND MATERIALS)
KNOW ALL PERSONS BY THESE PRESENTS that:
WUEREAS the City of Seal Beach, has awarded to AIS CONSTRUCTION COMPANY,
4285 CROOKED PALM ROAD, VENTURA, CA 93002
(Name and address of Contractor) •
( "Principal "), a contract (the "Contract ") for the work described as follows: Sand Retention Groin Repair,
including removal of existing temporary steel repair, removal of a portion of the existing concrete cap,
furnishing and installing new precast concrete sheetpiles, construction of new concrete cap, and, as
directed, repair of remaining concrete cap.
WHEREAS, Principal is required under the terms of the Contract and the California Civil Code to secure
the payment of claims of laborers, mechannics, rnaterialmen, and other persons as provided by law.
NOW, THEREFORE, we, the undersigned Principal, and ARCH INSURANCE COMPANY,
135 N. LOS ROBLES AVE., #825, PASADENA, CA 91101
(Name and address of Surety)
• ( "Surety ") a duly admitted surety insurer under the laws of the State of California. as Surety, are held and
firmly bound unto the Public Agency in the penal sum of THREE HUNDRED NINETY ONE THOUSAND SEVEN HUNDRED
TWENTY FIVE AND 00/100'5_
Dollars ($ 391,725.00 this amount being not less than fifty percent
(50%) of the total contract price, in lawful money of the United States of America, for the payment of
which sum well, and truly to be made, we bind ourselves, our heirs, executors, administrators, successors,
and assigns, jointly and severally, fnmly by these presents.
THE CONDITXON OF THIS OBLIGATION IS SUCH THAT, if the hereby bounded Principal, his, her
or its heirs, executors, administrators, successors or. assigns, or subcontractors, shall fail to pay any of the
persons named in Section 3 181 of the California Civil Code, or any amounts due under the Unemployment
Insurance Code with respect to work or labor performed under the Contract, or for any amounts required to
be deducted, withheld, and paid over to the Employment Development Department from the wages of
employees of the Principal and subcontractors pursuant to Section 13020 of the Unemployment Insurance
Code, with respect to work or labor performed under the Contract, the Surety will pay for the same in an
amount not exceeding the penal sum specified in this bond; otherwise, this obligation shall become null and
void.
This bond shall insure to the benefit of any of the persons named in Section 3181 of the California Civil
Code so as to give a right of action to such persons or their assigns in any suit brought upon the bond. In
case suit is brought upon this bond, Surety further agrees to pay all court costs and reasonable attorneys'
,fees in an amount fixed by the court.
FURTHER, the Surety, for value received, hereby stipulates and agrees that no change, extension of time,
alteration, addition or modification to the terms of the Contract, or of the work to be performed thereunder,
or the specifications for the same, shall in any way affect its obligations under this bond, and it does hereby
waive notice of any such change, extension of tune, alteration, addition, or modification to the terms of the
•
•
7
• •
Contract or to the work or to the specifications thereunder, Surety hereby Waives the provisions of
California Civil Code §§ 2845 and 2849.
IN WITNESS WHEREOF, two (2) identical counterparts of this instrument, each of which shall for all
purposes be deemed an original hereof, have been duly executed by Principal and Surety, on the date set
• forth below, the name of each corporate party being hereto affixed and these presents duly signed by ita
undersigned representative(s) pursuant to authority of its governing body.
Dated:
"Principal" "Surety"
AIS CONSTRUCTION COMPANY ARCH INSURANCE COMPANY
ANDY SHEAFFER , ' JULIA B
_ ��/
I P' IDENT / I. AT ORNEY IN FACT
By. , •
I Its
(Seal) (Seal)
Note: This bond must be dated, all signatures must be notarized, and
evidence of the authority of any person, signing as attorney-in-fact must be
• attached.
8
CALIFORNIA ALL- PURPOO ACKNOWLEDGEMENT
State of CALIFORNIA
County of RIVERSIDE
On JAN ¶ 3 'fp6 before me, DANNA K. BAKER, NOTARY PUBLIC
Name and Title of Officer (e.g., "Jane Doe, Notary Public")
personally appeared JULIA B. LEONARD, ATTORNEY IN FACT
Name(s) of Signer(s)
❑ personally known to me -OR- ❑ proved to me on the basis of satisfactory evidence to be the person(s) whose
name(s) is /are subscribed to the within instrument and
acknowledged to me that he /she /they executed the same in
his /her /their authorized capacity(ies), and that by his /her /their
signature(s) on the instrument the person(s), or the entity upon
DANNA K. BAKER behalf of which the person(s) acted, executed the instrument.
g
" COMM. #1386368
i r -1
NOTARY PUBLIC • CALIFORNIA WITNESS my hand and official seal.
RIVERSIDE COUNTY y
' M Comm, E res Nov. 22, 2008 alinnsi-- `` 4
i Signature of Notary Public
---------------------------------------- OPTI ONAL--------------------------------- _- ---- --
Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal
and reattachment of this form to another document.
Description of Attached Document
Title or Type of Document:
Document Date: Number of Pages:
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name: Signer's Name:
❑ Individual ❑ Individual
❑ Corporate Officer ❑ Corporate Officer
❑ Titles(s): ❑ Title(s):
❑ Partner - ❑ Limited ❑ General ❑ Partner - ❑ Limited El General
El Attorney -in -Fact ❑ Attorney -in -Fact
❑ Trustee RIGHT THUMBPRINT ❑ Trustee RIGHT THUMBPRINT
❑ Guardian or Conservator OF SIGNER ❑ Guardian or Conservator OF SIGNER
❑ Other: Top of Thumb here ❑ Other: Top of Thumb here
Signer Is Representing: Signer Is Representing:
BD -1133 09/00
.. ,, ,4 II . III
POWER OF ATTORNEY
ISSUED IN TWO ORIGINAL COUNTERPARTS BOND NO. SU5D19227
Know All Men By These Presents
That the Arch insurance Company, a corporation organized and existing under the laws of the State of Missouri having its
principal office in Kansas City, Missouri (hereinafter referred to as the "Company ") ooes hereoy appoint
Kenneth A Coate, Mark N. Gladding and Julia 3. Leonard of Riverside, CA (EACH)
its true and lawful Attorney(s) -in -Fact, to make, execute, seal, and deliver from the date of issuance of this power for and
on its behalf as surety, and as its act and deed:
Any and all bonds and undertakings
EXCEPTION: NO AUTHORITY is granted to make, execute, seal and deliver bonds or undertakings that guarantee the
payment or collection of any promissory note, check, draft or letter of credit.
This authority does not permit the same obligation to be split into two or more bonds in order to bring each such bond
within the dollar limit of authority as set forth herein.
The Company may revoke this appointment at any time.
The execution of such bonds and undertakings in pursuance of these presents shall be as binding upon the said
Company as fully and amply to all intents and purposes, as if the same had been duly executed and acknowledged by its
regularly elected officers at its principal office in Kansas City, Missouri.
This Power of Attorney is executed by authority of resolutions adopted by unanimous consent of the Board of Directors of
the Company on March 3, 2003, true and accurate copies of which are hereinafter set forth and are hereby certified to by
the undersigned Secretary as being in full force and effect:
"VOTED, That the Chairman of the Board, the President, or any Vice President, or their appointees designated in writing
and filed with the Secretary, or the Secretary shall have the power and authority to appoint agents and attomeys -in -fact,
and to authorize them to execute on behalf Of the Company, and attach the seal of the Company thereto, bonds and _
undertakings, recognizances, contracts of indemnity and other writings, obligatory in the nature thereof, and any such
officers of the Company may appoint agents for acceptance of process."
This Power of Attorney is signed, sealed and certified by facsimile under and by authority of the following resolution
adopted by the unanimous consent of the Board of Directors of the Company on March 3, 2003
VOTED, That the signature of the Chairman of the Board, the President, or any Vice President, or their appointees
designated in writing and filed with the Secretary, and the signature of the Secretary, the seal of the Company, and
certifications by the Secretary, may be affixed by facsimile on any power of attorney or bond executed pursuant to the
resolution adopted by the Board of Directors on March 3, 2603, and any such power so executed, sealed and certified
with respect to any bond or undertaking to which it is attached, shall continue to be valid and binding upon the Company.
00ML00 3 00 03 03
Page 1 of 2 Printed in U S.A.
•
s o eZ ar its zoroorc sea' i at":.xec J\' tr:eir
es:l,:ton� Whereof, me, 0,�:;�= "! \'';aS caJSeC tr1iS Irlsir::me::: to De I 1 •. .c .. ..
aJmonzec officers h s i 3tn oay of Seoternne. _ 2
Arr. insurance Com:.any
Attested an. Certified
cyJ- - Cp
\
CORPORATE 41
V SEAL
411 4`../ }incur'
Joseph S. L6 Corporate Secretary _ Thomas P. Luckstone, Vice President
STATE OF CONNECTICUT SS
COUNTY OF FAIRFIELD SS
I Melissa B. Gilligan, a Notary Public, do hereby certify that Thomas P. Luckstone and Joseph S. Labell personally known
to me to be the same persons whose names are respectively as Vice President and Corporate Secretary of the Arch
Insurance Company, a Corporation organized and existing under the laws of the State of Missouri, subscribed to the
foregoing instrument, appeared before me this day in person and severally acknowledged that they being thereunto duly
authorized signed, sealed with the corporate seal and delivered the said instrument as the free and voluntary act of said
corporation and as their own free and voluntary acts for the uses and purposes therein set forth.
MELISSA OFFICIAL G1WGAN Notary Public • 4 / / 4P . _ _ I, f_ -41
State ofConnecli„^ut Melissa B. Gilligan, Notary Public
My Commission Expires February 28, 2605 My commission expires 2 -28 -05
CERTIFICATION
I, Joseph S. Labell, Corporate Secretary of the Arch Insurance Company, do hereby certify that the attached Power of
Attorney dated September 18. 2003 on behalf of the person(s) as listed above is a true and correct copy and that
the same has been in full force and effect since the date thereof and is in full force and effect on.the date of this certificate;
and I do further certify that the said Thomas P. Luckstone, who executed the Power of Attorney as Vice President, was on
the date of execution of the attached Power of Attorney the duly elected Vice President of the Arch Insurance Company.
IN TESTIMONY WHEREOF, I have hereunto subscribed my name and affixed the corporate seal of the Arch insurance
Company on this 13TH day of JANUARY 20 06
( S - P
Joseph S ell, Corporate Secretary
•
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This Power of Attorney limits the acts of those named therein to the bonds and undertakings specifically named therein
and they have no authority to bind the Company except in the manner and to the extent herein stated.
• c sovance Co
s
W
Home Office: Kansas City, MO
00M1_0013 00 03 03
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•
Contract or to the work or to the specifications thereunder. Surety hereby waives the provisions of
California Civil Code §§ 2845 and 2849.
IN WITNESS WHEREOF, two (2) identical counterparts of this instrument, each of which shall for all
purposes be deemed an original hereof, have been duly executed by Principal and Surety, on the date set
forth below, the name of each corporate party being hereto affixed and these presents duly signed by its
undersigned representative(s) pursuant to authority of its governing body.
Dated:
"Principal" "Surety"
By: By:
Its Its
By: By:
Its Its
(Seal) (Seal)
Note: This bond must be dated, all signatures must be notarized, and
evidence of the authority of any person signing as attorney -in -fact must be
attached.
l - 8
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INDEMNIFICATION AND HOLD HARMLESS AGREEMENTAND
WAIVER OF SUBROGATION AND CONTRIBUTION
TITLE OF PROJECT OR WORK: Sand Retention Groi Repair
Indemnitor(s) (list all names) eatisiive
dAy
To the fullest extent permitted by law, Indemnitor hereby agrees, at its sole cost and expense, to defend,
protect, indemnify, and hold harmless the City of Seal Beach and its elected officials, officers, attorneys,
agents, employees, volunteers, successors, and assigns (collectively "Indemnitees ") from and against any
and all damages, costs, expenses, liabilities, claims, demands, causes of action, proceedings, expenses,
judgments, penalties, liens, and losses of any nature whatsoever, including fees of accountants, attorneys,
or other professionals and all costs associated therewith (collectively "Liabilities "), arising or claimed to
arise, directly or indirectly, out of, in connection with, resulting from, or related to any act, failure to act,
error, or omission of Indemnitor or any of its officers, agents, servants, employees, subcontractors,
materialmen, suppliers or their officers, agents, servants or employees, arising or claimed to arise, directly
or indirectly, out of, in connection with, resulting from, or related to the above - referenced contract,
agreement, license, or permit (the "Agreement ") or the performance or failure to perform any term,
provision, covenant, or condition of the Agreement, including this indemnity provision. This indemnity
provision is effective regardless of any prior, concurrent, or subsequent active or passive negligence by
Indemnitees and shall operate to fully indemnify Indenmitees against any such negligence. This indemnity
provision shall survive the termination of the Agreement and is in addition to any other rights or remedies
which Indemnitees may have under the law. Payment is not required as a condition precedent to an
Indemnitee's right to recover under this indemnity provision, and an entry of judgment against an
Indemnitee shall be conclusive in favor of the Indemnitee's right to recover under this indemnity provision.
Indemnitor shall pay Indemnitees for any attorneys fees and costs incurred in enforcing this
indemnification provision. Notwithstanding the foregoing, nothing in this instrument shall be construed to
encompass (a) Indemnitees' sole negligence or willful misconduct to the limited extent that the underlying
Agreement is subject to Civil Code § 2782(a) or (b) the contracting public agency's active negligence to the
limited extent that the underlying Agreement is subject to Civil Code § 2782(b). This indemnity is
effective without reference to the existence or applicability of any insurance coverage which may have
been required under the Agreement or any additional insured endorsements which may extend to
Indemnitees. Indemnitor, on behalf of itself and all parties claiming under or through it, hereby waives all
rights of subrogation and contribution against the Indemnitees, while acting within the scope of their duties,
from all claims, losses and liabilities arising out of or incident to activities or operations performed by or on
behalf of the Indemnitor regardless of any prior, concurrent, or subsequent active or passive negligence by
the Indemnitees. In the event there is more than one person or entity named in the Agreement as an
Indemnitor, then all obligations, liabilities, covenants and conditions under this instrument shall be joint
and several.
" Indemnitor" 4. A (
Nam Name:
By: !�,1% � /� By:
I NS Its
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10
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AGREEMENT TO COMPLY WITH CALIFORNIA LABOR LAW
REQUIREMENTS
[Labor Code §§ 1720, 1773.8, 1775, 1776, 1777.5, 1813, 1860, 1861, 3700]
The undersigned Contractor certifies that it is aware of and hereby agrees to fully comply with the
Following provisions of California law:
1. Contractor acknowledges that this contract is subject to the provisions of Division 2, Part 7,
Chapter 1 (commencing with Section 1720) of the California Labor Code relating to public works and the
awarding public agency ( "Agency ") and agrees to be bound by all the provisions thereof as though set forth
in full herein.
2. Contractor agrees to comply with the provisions of California Labor Code Section 1773.8 which
requires the payment of travel and subsistence payments to each worker needed to execute the work to the
extent required by law.
3. Contractor agrees to comply with the provisions of California Labor Code Sections 1774 and 1775
concerning the payment of prevailing rates of wages to workers and the penalties for failure to pay
prevailing wages. The Contractor shall, as a penalty to the Agency, forfeit not more than fifty dollars ($50)
for each calendar day, or portion thereof, for each worker paid less than the prevailing rates as determined
by the Director of Industrial Relations for the work or craft in which the worker is employed for any public
work done under the contract by Contractor or by any subcontractor.
4. Contractor agrees to comply with the provisions of California Labor Code Section 1776 which
require Contractor and each subcontractor to (1) keep accurate payroll records, (2) certify and make such
payroll records available for inspection as provided by Section 1776, and (3) inform the Agency of the
location of the records. The Contractor is responsible for compliance with Section 1776 by itself and all of
its subcontractors.
5. Contractor agrees to comply with the provisions of California Labor Code Section 1777.5
concerning the employment of apprentices on public works projects, and further agrees that Contractor is
responsible for compliance with Section 1777.5 by itself and all of its subcontractors.
6. Contractor agrees to comply with the provisions of California Labor Code Section 1813
concerning penalties for workers who work excess hours. The Contractor shall, as a penalty to the Agency,
forfeit twenty -five dollars ($25) for each worker employed in the execution of the contract by the
Contractor or by any subcontractor for each calendar day during which such worker is required or
permitted to work more than 8 hours in any one calendar day and 40 hours in any one calendar week in
violation of the provisions of Division 2, Part 7, Chapter 1, Article 3 of the California Labor Code.
7. California Labor Code Sections 1860 and 3700 provide that every contractor will be required to
secure the payment of compensation to its employees. In accordance with the provisions of California
Labor Code Section 1861, Contractor hereby certifies as follows:
"I am aware of the provisions of Section 3700 of the Labor Code which require every employer to
be insured against liability for worker's compensation or to undertake self - insurance in accordance with the
provisions of that code, and I will comply with such provisio • b - fore commencing the performance of the
work of this contract."
Olt
Date — Signa e 1� �L`!Ar,
11
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12
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STATEMENT ACKNOWLEDGING PENAL AND CIVIL PENALTIES
CONCERNING THE CONTRACTORS' LICENSING LAWS
[Business & Professions Code § 7028.15]
[Public Contract Code § 20103.5]
I, the undersigned, certify that I am aware of the following provisions of California law and that I, or the
entity on whose behalf this certification is given, hold a currently valid California contractor's license as set
forth below (required at time of award) :
Business & Professions Code § 7028.15:
(a) It is a misdemeanor for any person to submit a bid to a public agency in order to engage
in the business or act in the capacity of a contractor within this state without having a license therefor,
except in any of the following cases:
(1) The person is particularly exempted from this chapter.
(2) The bid is submitted on a state project governed by Section 10164 of the Public
Contract Code or on any local agency project governed by Section 20104 [now § 20103.5] of the Public
Contract Code.
(b) If a person has been previously convicted of the offense described in this section, the
court shall impose a fine of 20 percent of the price of the contract under which the unlicensed person
performed contracting work, or four thousand five hundred dollars ($4,500), whichever is greater, or
imprisonment in the county jail for not less than 10 days nor more than six months, or both.
In the event the person performing the contracting work has agreed to furnish materials
and labor on an hourly basis, "the price of the contract" for the purposes of this subdivision means the
aggregate sum of the cost of materials and labor famished and the cost of completing the work to be
performed.
(c) This section shall not apply to a joint venture license, as required by Section 7029.1.
However, at the time of making a bid as a joint venture, each person submitting the bid shall be subject to
this section with respect to his or her individual licensure.
(d) This section shall not affect the right or ability of a licensed architect, land surveyor, or
registered professional engineer to form joint ventures with licensed contractors to render services within
the scope of their respective practices.
(e) Unless one of the foregoing exceptions applies, a bid submitted to a public agency by a
contractor who is not licensed in accordance with this chapter shall be considered non - responsive and shall
be rejected by the public agency. Unless one of the foregoing exceptions applies, a local public agency
shall, before awarding a contract or issuing a purchase order, verify that the contractor was properly
licensed when the contractor submitted the bid. Notwithstanding any other provision of law, unless one of
the foregoing exceptions applies, the registrar may issue a citation to any public officer or employee of a
public entity who knowingly awards a contract or issues a purchase order to a contractor who is not
licensed pursuant to this chapter. The amount of civil penalties, appeal, and finality of such citations shall
be subject to Sections 7028.7 to 7028.13, inclusive. Any contract awarded to, or any purchase order issued
to, a contractor who is not licensed pursuant to this chapter is void.
(f) Any compliance or noncompliance with subdivision (e) of this section, as added by
Chapter 863 of the Statutes of 1989, shall not invalidate any contract or bid awarded by a public agency
during which time that subdivision was in effect.
(g) A public employee or officer shall not be subject to a citation pursuant to this section if
the public employee, officer, or employing agency made an inquiry to the board for the purposes of
13
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verifying the license status of any person or contractor and the board failed to respond to the inquiry within
three business days. For purposes of this section, a telephone response by the board shall be deemed
sufficient.
Public Contract Code § 20103.5:
In all contracts subject to this part where federal funds are involved, no bid submitted shall be
invalidated by the failure of the bidder to be licensed in accordance with the laws of this state. However, at
the time the contract is awarded, the contractor shall be properly licensed in accordance with the laws of
this state. The first payment for work or material under any contract shall not be made unless and until the
Registrar of Contractors verifies to the agency that the records of the Contractors' State License Board
indicate that the contractor was properly licensed at the time the contract was awarded. Any bidder or
contractor not so licensed shall be subject to all legal penalties imposed by law, including, but not limited
to, any appropriate disciplinary action by the Contractors' State License Board. The agency shall include a
statement to that effect in the standard form of pre - qualification questionnaire and financial statement.
Failure of the bidder to obtain proper and adequate licensing for an
award of a contract shall constitute a failure to execute the contract and
shall result in the forfeiture of the security of the bidder.
License no.: 5 ' O Class: piration date: 2 - �id —
Date - Signatur
2 Cp gna 411 Imo,, /
14
INSURANCE REQUIREMENTS
The Contractor shall at all times during the terms of the Contract carry, maintain, and keep in full force and
effect a policy or policies of comprehensive general liability insurance in which the City, along with its
City Council and each member thereof, and every officer, official, agent, attorney, employee or volunteer
of the City, is the named insured or is named as an additional insured with the Contractor in accordance
with the General Provisions. The insurance company issuing such policy(ies) must be acceptable to, and
approved by, the City Engineer and City Attorney. Contractor shall maintain limits of no less than One
Million Dollars ($1,000,000) combined single limit coverage per occurrence for personal injury or death or
property loss or damage which may arise from or relate directly or indirectly to the acts, operations or
omissions of the performance of the Contractor and/or its subcontractors and/or the employees, agents,
officers, officials or volunteers of either, in the performance of this Public Works Contract. Such insurance
shall include coverage for all automobiles utilized by Contractor's or any subcontractor's employees or
agents in the performance of the Contract. Contractor shall also provide an endorsement in the forms
included in Book II.
•
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16
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WORICE "°S COMPENSATION CERTIFICATE OF INSURANCE
WHEREAS, the CITY OF SEAL BEACH has required certain insurance to be provided by
NOW THEREFORE, the undersigned insurance company does hereby certify that it has issued the policy
or policies described below to the following named insureds and that the same are in force at this time.
1. This certificate is issued to: CITY OF SEAL BEACH, City Hall, 211 EIGHTH STREET, SEAL
BEACH, CA 90740 -6379.
2. The insureds under such policy or policies are:
3. Worker's Compensation Policy or Policies in a form approved by the Insurance Commissioner of
California covering all operations of the named insureds, as follows:
POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE
4. Said policy or policies shall not be canceled, voided or reduced in coverage or limits of liability,
unless and until thirty days' advance written notice thereof has been served upon the City Clerk of the
CITY OF SEAL BEACH.
By:
Its Authorized Representative
•
17
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WORKER'S COMPENSATION CERTIFICATE OF INSURANCE
WHEREAS, the CITY OF SEAL BEACH has required cettain insurance to be provided by
____Commerce and indu Insu rance
NOW SORE, the uadersigued insurance company does hereby certify that it has issued the policy
or policies described below to the following D.amed insureds and tbat the same are in force at tills time,
1. This certificate is issued to: CTI Y OF SEAL BEACH, City Halt, 211 Elqtall STREET, SEAL
BRACH, CA 90740 -6379.
2. The insureds corder stub policy or policies are: A I S Construction Company
3. Worms Compensation Policy or Policies in a form approved by the Insurance Commissioner of
Califoxx+a coveting all operations of the maned insure& as follows_
POLICY NUMBER EFFECTIVE DATE EXPI.ATION DATE
WC2955532 0110//06 01/01/07
WC2955533 01/01/06 01/01/07
4. Said policy or policies shall not be e&nooled, voided or reduced in coverage or limits of liability,
unless and until thirty days' advance written notice tlof has been served upon. the City Clerk of the
C1Y OF SEAL BFACR A 10 (ten) day notice will apply for nonpayment of premium.
ay: � � � •r � • � _
It A zesentativo
•
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18
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ADDITIONAL INSURED ENDORSE ,r :ENT C®r.'Pr EHENSWWE GENERAL
LIABILITY ,,/
e)a, addithOVAO
0 c
Name and address of named insured ( "Named Insured "):
O Y Peel C /eA2 . (itii
Name and address of Insurance Company ( "Company "):
OFFICIAL TITLE OF PROJECT: Sand Retention Groin Repair
Notwithstanding any inconsistent statement in the policy to which this endorsement is attached
(the "Policy ") or in any endorsement now or hereafter attached thereto, it is agreed as follows:
1. The City of Seal Beach, its elected officials, officers, attorneys, agents, employees, and volunteers are
additional insureds (the above named additional insureds are hereafter referred to as the "Additional
Insureds ") under the Policy in relation to those activities described generally above with regard to
operations performed by or on behalf of the Named Insured. The Additional Insureds have no liability
for the payment of any premiums or assessments under the Policy.
2. The insurance coverages afforded the Additional Insureds under the Policy shall be primary insurance,
and no other insurance maintained by the Additional Insureds shall be called upon to contribute with
the insurance coverages provided by the Policy.
3. Each insurance coverage under the Policy shall apply separately to each Additional Insured against
whom claim is made or suit is brought except with respect to the limits of the Company's liability.
4. Nothing in this contract of insurance shall be construed to preclude coverage of a claim by one insured
under the policy against another insured under the policy. All such claims shall covered as third -party
claims, i.e., in the same manner as if separate policies had been issued to each insured. Nothing
contained in this provision shall operate to increase or replicate the Company's limits of liability as
provided under the policy.
5. The insurance afforded by the Policy for contractual liability insurance (subject to the terms,
conditions and exclusions applicable to such insurance) includes liability assumed by the Named
Insured under the indemnification and/or hold harmless provision(s) contained in or executed in
conjunction with the written agreement(s) or permit(s) designated above, between the Named Insured
and the Additional Insureds.
6. The policy to which this endorsement is attached shall not be subject to cancellation, change in
coverage, reduction of limits (except as the result of the payment of claims), or non - renewal except
after written notice to Public Agency, by certified mail, return receipt requested, not less than thirty
(30) days prior to the effective date thereof. In the event of Company's failure to comply with this
notice provision, the policy as initially drafted will continue in full force and effect until compliance
with this notice requirement.
7. Company hereby waives all rights of subrogation and contribution against the Additional Insureds,
while acting within the scope of their duties, from all claims, losses and liabilities arising out of or
incident to the perils insured against in relation to those activities described generally above with
regard to operations performed by or on behalf of the Named Insured regardless of any prior,
concurrent, or subsequent active or passive negligence by the Additional Insureds.
8. It is hereby agreed that the laws of the State of California shall apply to and govern the validity,
construction, interpretation, and enforcement of this contract of insurance.
19
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MARINE COMPREHENSIVE
ADDITIONAL INSURED ENDORSEMENT gONIVEMMINSIMBYMEIVIERAL
LIABILITY
A I S Construction Company, P.O. Box 24620, Ventura, CA 93002 _
Name and address ofnarned ix+s>ued Maazad Iast¢ed"):
• XL S. :cleft insurance Co., 1201 N. Market St., Ste. 501, Wilmington, DE• 19801
Name and address oflnstsraace Company ("Company"):
OFFICIAL TITLE OF PROJECT% Sand. Retention Groin Repair •
Notwitbstandtng any inoansJtent statement in the policy to rich this aadoascment is attached
(the "Policy"). r in any endorsement new ant hereafter attached thereto, it is agreed as follows:
•
. 1- The City of Seal Beach, its- elected affiliate, offlans, attomeya, agents, employees, sad voluexteate are
aart iiotsorede (The above named additional imreds are hereafter referred to as the "Additional
bsauteds ") on t Policy relation to those 7113thriesa described gextexelly above with regard to
operations performed by or ozf behalf of the Named Insured. The Additional Darn reds have no 3iabuity
for th.e past of any pre rchmos or assessments under the Policy.
2. The iasizanee covergg s worded the Additioea1Insureds imudsr to Policy shall be primary insurance,
and no other insurence maintained by the Ad4doual Insureds shall be caller) upon to contribute with
• the insurance coverages provided by the Policy.
3. Bach Waranee coverage under the Policy shall apply aeparetoly to each Aa kored apafnat
whom claim is made or suit is brought except whit respect to the Iim11s of the Cotes liability.
4 . N o t h i n g i n t h i s c o n t r a c t o f i n s u m m o e s h a l l be construed t o preelade c o v e r a g e oi;'a o a by one insured
wader the policy against another insured under the policy. All auch claims shall covered es third -party
claim, Le, i� , the same manner as if separate policies bad been issued to each insured. Noting
' can'Faieed in this provision shall operate to increase or replicate this Company's limits of liability as
provided wider the policy.
5. The insurance afforded by the Policy for contractual liablity insurance (subject to the terms,
oouditiow and excluaiiona applica11e to such insurance) includes 11abifity ass.,a d by the Named
Insured under the indemnification and/or hold bawXess provision(s) contained is or exe led in
collimation with the written ag cnt(s) or permit(e) designated above, between the, Named. Insured
and the Adrlif+nm "1 Insureds.
6. The policy to which this endorsement Is attached sly not be eebleot to mediation orange in
coverage, reduction. of limits (except as the result of the payment of claims), or non-renewal except
after written xaotioe to Public, Agency, by oertifzed ate, return receipt requested, not less that thirty _
- - . •• • (30 i9ays' psiar to the effective date thereof. 3c,. theevera of Company's f dime to comply with this - - -
notice provision, the policy es n±tiaEy drafted will continue in. full force and ollbct until compliance
withthis aottcerequirement A 10 (ten) day notice will apply for nonpayment of premium.
7. Company hereby waives all rights of subrogation and contribution against the Additional. bawds,
while acting within the scope of their due ea, iron all claims, losses and liabilities arising out of or
incident to the puts insured against in relation. to dose activities described generally above with.
regard to operations' performed by or on behalf of tbtr N it Insured regardless of any prior
coteerront, or subsequent active or passive negligence by the Additional Insureds.
8. It is hereby agreed that the laws of the State of Calitornia shall apply to.and govern the validity,
contrition, mterpretataon, and enforcement of this contract of insurance.
•
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19
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9. This endorsement sod ILgtioed given hereunder tha11 be sent to Public Agency at
Dlreator of Public Wow
City of Seal Beaa'h
2118th. Street, 2 Floor
Seal Basal CA90740 •
11 Except as stated above and not in conflict viith this endorsement, nothing oordainLed harem shall be
held to waive, alinr or eldertil trzty of the lints, agreements, or eomItssians of the policy to, whims this
endorsement is attached.
TYPE OF COVERAGES TO Wld[CS POLICYPBRIOD mars OF
• T s EtmoR T ATI:M SES FROMPI'O LIABLUTY
Marine Comprehensive Liability 03/12/05 - 03112/06 (See Attached Certificate)
11. Scheduled terns or locations are to be idostified on an attached. sheet The tbRowing inalusians
relate to the above coverages. Includes:
•
•
Contractual Liability OE Explosion Hated
a owners/La 010 /11:nards • 111 Collapse Ifinard
)g M w Ig Underground PmpeatyI7a,raeg
• Produce /Completed Oparat ens I$ Pollution.Iiabilify (Limited per policy form)
ig Broad Form Property Damage 0 Liquor Liability
• >teuded BediIy Injury ❑
X Brand Item Comprehensive D
General Liability Endorsement
12. A Si deduotffle or 0 self -fired retention (check one) of $ 10 COO •
. applies to all eoverage(s) c*pt Cove rage C - Medical Expense Limit On (Any ori)�
(if none, so state). The dela is applicable ❑ per claim or 0( per accurenoo (check
one).
•
13. This 1s an M occurrence or C7 claims made policy (check one).
14 ' This endoxscraent is effective cc 02101/06 • . at 1201 AJvL and lictms a parr
ofPollcy Number PXMC850504
` )1Av1 Vt (pent name), hereby
mare =der penalty op ofpesjuzylinder the laws of ie State of Cam, tliat 1 have din authority to bind
the Company to this ectionternaut and flat bymy execution beteg I do so bind the Company.
Executed . an 4 tak 31 , 20 06
Signature 6 • , . • Representative
(Or al signature • only; •no facsimile signature or stature
accepted)
Phone N'o. ( 805 )585 -6100
20
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9. This endorsement and all notices given hereunder shall be sent to Public Agency at:
Director of Public Works
City of Seal Beach
211 8th Street, 2nd Floor
Seal Beach CA 90740
10. Except as stated above and not in conflict with this endorsement, nothing contained herein shall be
held to waive, alter or extend any of the limits, agreements, or exclusions of the policy to which this
endorsement is attached.
TYPE OF COVERAGES TO WHICH POLICY PERIOD LIMITS OF
THIS ENDORSEMENT ATTACHES FROM/TO LIABILITY
11. Scheduled items or locations are to be identified on an attached sheet. The following inclusions
relate to the above coverages. Includes:
❑ Contractual Liability ❑ Explosion Hazard
❑ Owners/Landlords/Tenants ❑ Collapse Hazard
❑ Manufacturers /Contractors ❑ Underground Property Damage
❑ Products/Completed Operations ❑ Pollution Liability
❑ Broad Form Property Damage ❑ Liquor Liability
❑ Extended Bodily Injury ❑
❑ Broad Form Comprehensive ❑
❑ General Liability Endorsement
12. A ❑ deductible or ❑ self-insured retention (check one) of $
applies to all coverage(s) except:
(if none, so state). The deductible is applicable ❑ per claim or ❑ per occurrence (check
one).
13. This is an ❑ occurrence or ❑ claims made policy (check one).
14. This endorsement is effective on at 12:01 A.M. and forms a part
of Policy Number
I, (print name), hereby
declare under penalty of perjury under the laws of the State of California, that I have the authority to bind
the Company to this endorsement and that by my execution hereof, I do so bind the Company.
Executed , 20
Signature of Authorized Representative
(Original signature only; no facsimile signature or initialed signature
accepted)
Phone No.: ( )
20
• •
i DD1T ONAL INSURED ENDORSEMENT AUTOr.r®BOLE LIABILITY
•
/ 4. - ■ / . 1 /4 _/Aid
Name and address of named msured ( "Named Insured "): •
Name and address of Insurance Company ( "Company "):
OFFFICAL TITLE OF PROJECT: Sand Retention Groin Repair
Notwithstanding any inconsistent statement in the policy to which this endorsement is attached (the
"Policy ") or in any endorsement now or hereafter attached thereto, it is agreed as follows:
The City of Seal Beach, its elected officials, officers, attorneys, agents, employees, and volunteers are additional
insureds (the above named additional insureds are hereafter referred to as the "Additional Insureds ") under the
Policy in relation to those activities described generally above with regard to operations performed by or on behalf
of the Named Insured. The Additional Insureds have no liability for the payment of any premiums or assessments
under the Policy.
1. The insurance coverages afforded the Additional Insureds under the Policy shall be primary insurance, and no
other insurance maintained by the Additional Insureds shall be called upon to contribute with the insurance
coverages provided by the Policy.
2. Each insurance coverage under the Policy shall apply separately to each Additional Insured against whom claim
is made or suit is brought except with respect to the limits of the Company's liability.
3. Nothing in this contract of insurance shall be construed to preclude coverage of a claim by one insured under
the policy against another insured under the policy. All such claims shall covered as third -party claims, i.e., in
the same manner as if separate policies had been issued to each insured. Nothing contained in this provision
shall operate to increase or replicate the Company's limits of liability as provided under the policy.
4. The insurance afforded by the Policy for contractual liability insurance (subject to the terms, conditions and
exclusions applicable to such insurance) includes liability assumed by the Named - Insured under the
indemnification and/or hold harmless provision(s) contained or executed in conjunction with the written
agreement(s) or permit(s) designated above, between the Named Insured and the Additional Insureds.
5. The policy to which this endorsement is attached shall not be subject to cancellation, change in coverage,
reduction of limits (except as the result of the payment of claims), or non - renewal except after written notice to
Public Agency, by certified mail, return receipt requested, not less than thirty (30) days prior to the effective
date thereto. In the event of Company's failure to comply with this notice provision, the policy as initially
drafted will continue in full force and effect until compliance with this notice requirement.
6. Company hereby waives all rights of subrogation and contribution against the Additional Insureds, while acting
within the scope of their duties, from all claims, losses and liabilities arising out of or incident to the perils
insured against in relation to those activities described generally above with regard to operations performed by
or on behalf of the Named Insured regardless of any prior, concurrent, or subsequent active or passive
negligence by the Additional Insureds.
It is hereby agreed that the laws of the State of California shall apply to and govern the validity, construction,
interpretation, and enforcement of this contract of insurance.
This endorsement and all notices given hereunder shall be sent to Public Agency at:
Director of Public Works
City of Seal Beach
211 8th Street, 2 Floor
Seal Beach CA 90740
7. Except as stated above and not in conflict with this endorsement, nothing contained herein shall be held to
waive, alter or extend any of the limits, agreements, or exclusions of the policy to which this endorsement is
attached.
21
. 0
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED CA 71 35 01 88
American States Insurance
A SAFECO Company
This endorsement modified insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
GARAGE COVERAGE FORM
TRUCKERS COVERAGE FORM
Endorsement effective:
02/01/06
Named Insured: Policy Number:
A I S Construction Company 01 CG70064620
Schedule
Name of Person or Organization: Any person or organization that the named insured
is obligated by virtue of a written contract or
agreement to provide insurance such as is afforded
by this policy
Address:
Premium: $ 100.00
(If no entry appears above, information required to complete this endorsement will be
shown in the Declarations as applicable to this endorsement.)
A. Under LIABILITY COVERAGE WHO IS AN INSURED is changed to include as
an "insured" the person(s) or organization(s) shown in the Schedule, but only with
respect to "bodily injury" or "property damage" resulting from the acts or omissions of:
1. You;
2. Any of your employees or agents;
3. Any person, except the additional insured or any employee or
agent of the additional insured, operating a covered "auto" with the
permission of any of the above.
B. The insurance afforded by this endorsement does not apply:
To "bodily injury" or "property damage" arising out of the sole negligence of the
person(s) or organization(s) shown in the Schedule.
Page 1 of 1
. •
TYPE OF COVERAGES TO WHICH POLICY PERIOD
LIMITS OF
THIS ENDORSEMENT ATTACHES FROM/ TO
LIABILITY
Scheduled items or locations are to be identified on an attached sheet. The following inclusions relate to
the above coverages. Includes:
❑ Any Automobiles ❑ Truckers Coverage
❑ All Owned Automobiles ❑ Motor Carrier Act
❑ Non -owned Automobiles ❑ Bus Regulatory Reform Act
❑ Hired Automobiles ❑ Public Livery Coverage
❑ Scheduled Automobiles ❑
❑ Garage Coverage ❑
11. A ❑ deductible or ❑ self - insured retention (check one) of $ applies to all
coverage(s) except:
(if none, so state). The deductible is applicable ❑ per claim or ❑ per occurrence (check one).
12. This is an ❑ occurrence or ❑ claims made policy (check one).
13. This endorsement is effective on at 12:01 A.M. and forms a part of Policy
Number .
1, (print name), hereby
declare under penalty of perjury under the laws of the State of California, that I have the authority to bind the
Company to this endorsement and that by my execution hereof, I do so bind the Company.
Executed , 20
Signature of Authorized Representative
(Original signature only; no facsimile signature or initialed signature
accepted)
Phone No.: ( )
22
• •
ADDITIONAL INSURED ENDORSEMENT EXCESS LIABILITY
I I i(LelAmAa a,&__WL..thuA061 harm-
Name and address of named insured ( "Named Insured "):
COQ MO 'on 0 Witcuit/ Ontkap 4(
Name and address of Insurance Company ( "Company "):
OFFICIAL TITLE OF PROJECT: Sand Retention Groin Repair
Notwithstanding any inconsistent statement in the policy to which this endorsement is attached (the
"Policy ") or in any endorsement now or hereafter attached thereto, it is agreed as follows:
1. The City of Seal Beach, its elected officials, officers, attorneys, agents, employees, and volunteers
are additional insureds (the above named additional insureds are hereafter referred to as the "Additional Insureds ")
under the Policy in relation to those activities described generally above with regard to operations performed by or
on behalf of the Named Insured. The Additional Insureds have no liability for the payment of any premiums or
assessments under the Policy.
2. The insurance coverages afforded the Additional Insureds under the Policy shall be primary
insurance, and no other insurance maintained by the Additional Insureds shall be called upon to contribute with the
insurance coverages provided by the Policy.
3. Each insurance coverage under the Policy shall apply separately to each Additional Insured
against whom claim is made or suit is brought except with respect to the limits of the Company's liability.
4. Nothing in this contract of insurance shall be construed to preclude coverage of a claim by one
insured under the policy against another insured under the policy. All such claims shall covered as third -party
claims, i.e., in the same manner as if separate policies had been issued to each insured. Nothing contained in this
provision shall operate to increase or replicate the Company's limits of liability as provided under the policy.
5. The insurance afforded by the Policy for contractual liability insurance (subject to the terms,
conditions and exclusions applicable to such insurance) includes liability assumed by the Named Insured under the
indemnifica-tion and/or hold harmless provision(s) contained in or executed in conjunction with the written
agreement(s) or permit(s) designated above, between the Named Insured and the Additional Insureds.
6. The policy to which this endorsement is attached shall not be subject to cancellation, change in
coverage, reduction of limits (except as the result of the payment of claims), or non - renewal except after written
notice to Public Agency, by certified mail, return receipt requested, not less than thirty (30) days prior to the
effective date thereto. In the event of Company's failure to comply with this notice provision, the policy as initially
drafted will continue in full force and effect until compliance with this notice requirement.
7. Company hereby waives all rights of subrogation and contribution against the Additional Insureds,
while acting within the scope of their duties, from all claims, losses and liabilities arising out of or incident to the
perils insured against in relation to those activities described generally above with regard to operations performed by
or on behalf of the Named Insured regardless of any prior, concurrent, or subsequent active or passive negligence by
the Additional Insureds.
8. It is hereby agreed that the laws of the State of California shall apply to and govern the validity,
construction, interpretation, and enforcement of this contract of insurance.
23
9. This endorsement and all notices given hereunder shall be sent to Public Agency at:
Director of Public Works
City of Seal Beach
211 8th Street, 2 Floor
Seal Beach CA 90740
10. Except as stated above and not in conflict with this endorsement, nothing contained herein shall be
held to waive, alter or extend any of the limits, agreements, or exclusions of the policy to which
this endorsement is attached.
TYPE OF COVERAGES TO WHICH POLICY PERIOD
LIMITS OF
THIS ENDORSEMENT ATTACHES FROM/TO
LIABILITY
❑ Following Form
❑ Umbrella Liability
0
10. Applicable underlying coverages:
INSURANCE COMPANY POLICY NO.
AMOUNT
11. The following inclusions, exclusions, extensions or specific provisions relate to the above
coverages:
12. A ❑ deductible or ❑ self-insured retention (check one) of $
applies to all coverage(s) except: (if none,
so state). The deductible is applicable ❑ per claim or ❑ per occurrence (check one).
13. This is an ❑ occurrence or ❑ claims made policy (check one).
14. This endorsement is effective on at 12:01 A.M. and forms a part of
Policy Number
I, (print name), hereby declare under
penalty of perjury under the laws of the State of California, that I have the authority to bind the Company to this
endorsement and that by my execution hereof, I do so bind the Company.
Executed , 20
Signature of Authorized Representative
(Original signature only; no facsimile signature or initialed signature
accepted)
Phone No.: ( )
24